title: Graft-versus-tumor effect after allogeneic stem cell transplantation in HIV-positive patients with high-risk hematologic malignancies.
abstract: Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is a well-established therapeutic option for hematological malignancies. Combination antiretroviral therapy (cART) has enabled the treatment of medical conditions in patients infected with the human immunodeficiency virus (HIV) in the same way as in the general population. Moreover, improvements in supportive care have allowed HIV-infected patients with life-threatening hematological disorders to be treated with Allo-HSCT. We report on four HIV-infected patients with hematological malignancies receiving an Allo-HSCT in our institution, and on the use of donor lymphocyte infusions to successfully treat post-Allo-HSCT relapse. Of note, one of them is the first HIV(+) patient to receive a "dual transplant" (unrelated umbilical cord blood stem cells combined with mobilized T cell-depleted CD34(+) stem cells from a mismatched third party donor). cART drugs interactions were satisfactorily managed. This approach provided long-term control of the hematological disease. Nevertheless, despite adequate immune reconstitution, infections were the main cause of morbidity and mortality after Allo-HSCT.
authors.affiliation: 1 Department of Hematology-BMT Unit , H.G.U. Gregorio Marañón, Madrid, Spain .
authors.forename: David
authors.initials: D
authors.lastname: Serrano
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Pascual
authors.initials: P
authors.lastname: Balsalobre
authors.forename: Mi
authors.initials: M
authors.lastname: Kwon
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rodriguez-Macias
authors.forename: Jorge
authors.initials: J
authors.lastname: Gayoso
authors.forename: Javier
authors.initials: J
authors.lastname: Anguita
authors.forename: Ismael
authors.initials: I
authors.lastname: Buño
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: José L
authors.initials: JL
authors.lastname: Díez-Martín
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D016896:Treatment Outcome